Acinar

Sam is still recovering from the latest surgery but should be getting out of the hospital soon.  They have started her on a liquid diet and she is able to get out of bed and walk for a minute or two a few times a day.  It appears the new connections they made have been successful.  The excitement the doctors showed when things started working after five days told me how concerned they actually were about it. 

Her abdomen did become infected as they said it would. Sam is receiving antibiotic intravenously for it.  However she is also receiving TPN, fluids, and other nutrients intravenously through her port and the IV’s in her arms.  The IV’s though have become a problem causing her swelling and tenderness to her arms.  Hopefully as she starts to eat she can get off the TPN, freeing up her port so they will be able to remove the IV’s from her arms.

As for the lymph node removed, it did test positive.  What this means we're not yet sure.  At this time it really does not change our plans.  The plan is still for Sam to have follow up Chemo treatments.  It is unknown if the lymph node became infected before or after the surgery.  To the doctors I don’t think it matters as to the treatment. Sam and I believe that it was there before the surgery.  When Sam was receiving Chemo in Chicago she would notice a lymph node that would swell up, in that same area where this lymph was removed from. We believe it must be the same. 

As for what’s next....  The doctors here in Miami have initiated conversations with the doctors in Chicago.   After examining the removed tumors from Sam, pathologist have reclassified the type of cancer she is suffering from, to one which is very similar to Pancreatoblastoma.  Acinar cell carcinoma.  This is also a rare type of Pancreatic cancer occuring in only 1% of all pancreatic cancers. The reason they originally thought it was Pancreatoblastoma over Acinar was histology that Pancreatoblastoma usually occurs in juvenile females.  Acinar usually occurs in elderly males.  Treatment-wise we don’t believe it changes anything.  There is more data on Acinar but still no established standard protocol.

What this does change is our Oncologist.  Dr. Cohn at the University of Chicago Hospitals works out of pediatrics and deals with juvenile cancers.  She stated she would have to refer us over to the adult side because she has never dealt with Acinar. No longer being able to be treated on the 6^th floor of Comer broke Sam’s heart as she loves and misses the friends she made there. 

The good news is that the doctors here are putting us on the fast track to get Sam home.  As soon as we can get Sam strong enough to travel we’ll head back North. There are some complications and concerns about being away from the transplant team (especially when the treatments start) but we are working on that.  Right now Sam would really benefit from being back home with family and friends... Oh and that dog of hers. Hopefully this will occur within the next two weeks.

We will keep you posted.

 Lots of Love,

Chris